Abnormal agitated saline study results after tetralogy of fallot repair

Robert D. Tunks, Piers C.A. Barker, Jason N. Johnson, Michael J. Campbell

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Residual intracardiac or extracardiac shunting is frequently seen in patients with repaired congenital heart disease and can cause systemic hypoxemia. We present the case of an adult with tetralogy of Fallot who underwent two corrective surgical procedures as a child with subsequent pulmonary valve replacement due to residual pulmonary insufficiency. Further details of her operative history were otherwise unknown. After being lost to follow-up for many years, she presented with unexplained cyanosis and a markedly abnormal agitated saline study on transthoracic echocardiography in which only the left heart filled after contrast administration. We review the differential diagnosis for such a presentation and discuss the utility of cardiac magnetic resonance imaging (MRI) to define the etiology. Cardiac MRI, a frequently used imaging modality to longitudinally assess adult patients with congenital heart disease, provides excellent image quality of cardiac structures and the ability to perform angiography in a variety of imaging planes. These advantages render cardiac MRI, a useful modality to determine the etiology of unexplained cyanosis in these patients as both intracardiac and extracardiac shunts can be detected. Mini-Abstract Residual intracardiac or extracardiac shunting is frequently seen in patients with repaired congenital heart disease and can cause systemic hypoxemia. We present the case of an adult with tetralogy of Fallot who presented with unexplained cyanosis and an abnormal agitated saline study in which only the left heart fi lled after contrast administration. We discuss the differential diagnosis and use of cardiac magnetic resonance imaging (MRI) to defi ne the etiology. By providing excellent image quality of cardiac structures and the ability to perform angiography in multiple imaging planes, cardiac MRI is a useful modality to determine the etiology of unexplained cyanosis in these patients.

Original languageEnglish (US)
Pages (from-to)E307-E309
JournalEchocardiography
Volume30
Issue number10
DOIs
StatePublished - Nov 1 2013

Fingerprint

Tetralogy of Fallot
Cyanosis
Magnetic Resonance Imaging
Heart Diseases
Angiography
Differential Diagnosis
Pulmonary Valve
Lost to Follow-Up
Echocardiography
History
Lung

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Tunks, Robert D. ; Barker, Piers C.A. ; Johnson, Jason N. ; Campbell, Michael J. / Abnormal agitated saline study results after tetralogy of fallot repair. In: Echocardiography. 2013 ; Vol. 30, No. 10. pp. E307-E309.
@article{962333a80a1844d79ffeb2c18f464462,
title = "Abnormal agitated saline study results after tetralogy of fallot repair",
abstract = "Residual intracardiac or extracardiac shunting is frequently seen in patients with repaired congenital heart disease and can cause systemic hypoxemia. We present the case of an adult with tetralogy of Fallot who underwent two corrective surgical procedures as a child with subsequent pulmonary valve replacement due to residual pulmonary insufficiency. Further details of her operative history were otherwise unknown. After being lost to follow-up for many years, she presented with unexplained cyanosis and a markedly abnormal agitated saline study on transthoracic echocardiography in which only the left heart filled after contrast administration. We review the differential diagnosis for such a presentation and discuss the utility of cardiac magnetic resonance imaging (MRI) to define the etiology. Cardiac MRI, a frequently used imaging modality to longitudinally assess adult patients with congenital heart disease, provides excellent image quality of cardiac structures and the ability to perform angiography in a variety of imaging planes. These advantages render cardiac MRI, a useful modality to determine the etiology of unexplained cyanosis in these patients as both intracardiac and extracardiac shunts can be detected. Mini-Abstract Residual intracardiac or extracardiac shunting is frequently seen in patients with repaired congenital heart disease and can cause systemic hypoxemia. We present the case of an adult with tetralogy of Fallot who presented with unexplained cyanosis and an abnormal agitated saline study in which only the left heart fi lled after contrast administration. We discuss the differential diagnosis and use of cardiac magnetic resonance imaging (MRI) to defi ne the etiology. By providing excellent image quality of cardiac structures and the ability to perform angiography in multiple imaging planes, cardiac MRI is a useful modality to determine the etiology of unexplained cyanosis in these patients.",
author = "Tunks, {Robert D.} and Barker, {Piers C.A.} and Johnson, {Jason N.} and Campbell, {Michael J.}",
year = "2013",
month = "11",
day = "1",
doi = "10.1111/echo.12318",
language = "English (US)",
volume = "30",
pages = "E307--E309",
journal = "Echocardiography",
issn = "0742-2822",
publisher = "Wiley-Blackwell",
number = "10",

}

Abnormal agitated saline study results after tetralogy of fallot repair. / Tunks, Robert D.; Barker, Piers C.A.; Johnson, Jason N.; Campbell, Michael J.

In: Echocardiography, Vol. 30, No. 10, 01.11.2013, p. E307-E309.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Abnormal agitated saline study results after tetralogy of fallot repair

AU - Tunks, Robert D.

AU - Barker, Piers C.A.

AU - Johnson, Jason N.

AU - Campbell, Michael J.

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Residual intracardiac or extracardiac shunting is frequently seen in patients with repaired congenital heart disease and can cause systemic hypoxemia. We present the case of an adult with tetralogy of Fallot who underwent two corrective surgical procedures as a child with subsequent pulmonary valve replacement due to residual pulmonary insufficiency. Further details of her operative history were otherwise unknown. After being lost to follow-up for many years, she presented with unexplained cyanosis and a markedly abnormal agitated saline study on transthoracic echocardiography in which only the left heart filled after contrast administration. We review the differential diagnosis for such a presentation and discuss the utility of cardiac magnetic resonance imaging (MRI) to define the etiology. Cardiac MRI, a frequently used imaging modality to longitudinally assess adult patients with congenital heart disease, provides excellent image quality of cardiac structures and the ability to perform angiography in a variety of imaging planes. These advantages render cardiac MRI, a useful modality to determine the etiology of unexplained cyanosis in these patients as both intracardiac and extracardiac shunts can be detected. Mini-Abstract Residual intracardiac or extracardiac shunting is frequently seen in patients with repaired congenital heart disease and can cause systemic hypoxemia. We present the case of an adult with tetralogy of Fallot who presented with unexplained cyanosis and an abnormal agitated saline study in which only the left heart fi lled after contrast administration. We discuss the differential diagnosis and use of cardiac magnetic resonance imaging (MRI) to defi ne the etiology. By providing excellent image quality of cardiac structures and the ability to perform angiography in multiple imaging planes, cardiac MRI is a useful modality to determine the etiology of unexplained cyanosis in these patients.

AB - Residual intracardiac or extracardiac shunting is frequently seen in patients with repaired congenital heart disease and can cause systemic hypoxemia. We present the case of an adult with tetralogy of Fallot who underwent two corrective surgical procedures as a child with subsequent pulmonary valve replacement due to residual pulmonary insufficiency. Further details of her operative history were otherwise unknown. After being lost to follow-up for many years, she presented with unexplained cyanosis and a markedly abnormal agitated saline study on transthoracic echocardiography in which only the left heart filled after contrast administration. We review the differential diagnosis for such a presentation and discuss the utility of cardiac magnetic resonance imaging (MRI) to define the etiology. Cardiac MRI, a frequently used imaging modality to longitudinally assess adult patients with congenital heart disease, provides excellent image quality of cardiac structures and the ability to perform angiography in a variety of imaging planes. These advantages render cardiac MRI, a useful modality to determine the etiology of unexplained cyanosis in these patients as both intracardiac and extracardiac shunts can be detected. Mini-Abstract Residual intracardiac or extracardiac shunting is frequently seen in patients with repaired congenital heart disease and can cause systemic hypoxemia. We present the case of an adult with tetralogy of Fallot who presented with unexplained cyanosis and an abnormal agitated saline study in which only the left heart fi lled after contrast administration. We discuss the differential diagnosis and use of cardiac magnetic resonance imaging (MRI) to defi ne the etiology. By providing excellent image quality of cardiac structures and the ability to perform angiography in multiple imaging planes, cardiac MRI is a useful modality to determine the etiology of unexplained cyanosis in these patients.

UR - http://www.scopus.com/inward/record.url?scp=84887015442&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887015442&partnerID=8YFLogxK

U2 - 10.1111/echo.12318

DO - 10.1111/echo.12318

M3 - Article

C2 - 24102990

AN - SCOPUS:84887015442

VL - 30

SP - E307-E309

JO - Echocardiography

JF - Echocardiography

SN - 0742-2822

IS - 10

ER -